Personal Accident, Sickness & Travel. Policy Document

Transcription

1 Personal ccident, Sickness & Travel Policy Document

2 Caunce O'Hara & Co Ltd Caunce O Hara & Company Limited was established in 1995 and now ranks as one of the top 100 Independent rokers in the United Kingdom. From their offices in Manchester they deliver innovative lateral solutions to clients insurance programs. Caunce O Hara has been arranging insurance cover for freelance contractors since they came into existence. They understand the marketplace and have been able to offer the breadth and flexibility of cover that is required when insuring many different types of occupations and activities. Few Insurers understand this risk and we believe we offer value for money insurance policies written on the widest available cover. We are keen on providing the best in customer service and believe our administration and claim paying systems are fast, efficient and reliable. For more information please access Caunce O Hara s website or schemes@caunceohara.co.uk Royal & Sun lliance Insurance plc Royal & Sun lliance has over 300 years heritage, being established as The Sun in Royal & Sun lliance is one of the worlds leading multi-national quoted insurance groups. They have the capability to write business in over 130 countries, with major operations in UK, Scandinavia, Canada, Ireland, sia, the Middle East and Latin merica. Within the UK, Royal & Sun lliance is the largest commercial lines insurer and includes covering the insurance and risk management needs of a significant number of the FTSE 100 companies. They have full multi-distribution capability, writing business through both brokers and corporate partners Royal & Sun lliance s solid credit rating demonstrates their strength: Standard & Poors (positive) 16/10/2010.M. est (stable) 26/2/2009 Moody s 2 (stable) 02/12/2008

3 Personal ccident Illness and Travel Policy 1 THIS POLICY (ND THE SCHEDULE WHICH FORMS N INTEGRL PRT OF THE POLICY) IS LEGL CONTRCT IT NEEDS TO E EXMINED THOROUGHLY TO ENSURE IT MEETS THE INSURED S REQUIREMENTS IF IT DOES NOT MEET THE INSURED S REQUIREMENTS CUNCE O HR & COMPNY LTD NEEDS TO E CONTCTED WITHOUT UNDUE DELY THE FCTS WHICH YOU HVE PROVIDED TO THE INSURER HVE EEN TKEN INTO CCOUNT IN THE SSESSMENT ND CCEPTNCE OF THIS INSURNCE NY SUSEQUENT CHNGES TO THOSE FCTS NEED TO E DECLRED FILURE TO DO SO MY INVLIDTE THE POLICY OR RESULT IN CERTIN COVERS NOT OPERTING FULLY IF THERE RE NY DOUTS S TO WHETHER FCT IS MTERIL OR NOT CUNCE O HR & COMPNY LTD NEEDS TO E CONTCTED IMMEDITELY Royal & Sun lliance Insurance plc (herein called the Company) and the Insured agree that This Policy the Schedule (including any Schedule issued in substitution) and any Endorsement shall be considered one document and any word or expression to which a specific meaning has been attached shall bear such meaning wherever it appears The Proposal or any information supplied by the Insured shall be incorporated in the contract The Company will provide the insurance described in this Policy subject to the Terms and Conditions for the Period of Insurance shown in the Schedule and any subsequent period for which the Insured shall pay and the Company shall agree to accept the premium

4 2 Personal ccident Illness and Travel Policy Contents Section Page No General Definitions 9 Definition of Operative Times 13 General Conditions 14 General Claims Settlement Conditions 15 General Policy Exclusions 16 Personal ccident Insurance Section 17 aggage Insurance Section 23 Cancellation Curtailment including 25 Replacement Rearrangement and Change of Itinerary Insurance Section Evacuation Insurance Section 26 Hijack Kidnap and Detention 27 Insurance Section Medical Repatriation and Emergency 28 Travel Expenses Insurance Section Money and Credit Cards 30 Insurance Section Personal Liability Insurance Section 31 Personal Security Specialist Expenses 33 Insurance Section Travel Delay Insurance Section 34 Travel Document Insurance Section 35 Sickness enefit Extension 36 Fair Processing Notice 37 Complaints Procedure 39

5 Personal ccident Illness and Travel Policy 3 Claim Notification Conditions that apply to the policy and in the event of a claim are set out in this policy wording It is important that you comply with all policy conditions and you should familiarise yourself with any requirements Directions for claim notification are included under General Claims Settlement Conditions and Claims Settlement Conditions applying to each Section Please be aware that events that may give rise to a claim under the insurance must be notified to us as soon as reasonably possible although there are some situations where immediate notice is required Further guidance is contained in this policy wording Claims Conditions require you to provide us with any reasonable assistance and evidence that we require concerning the cause and value of any claim Ideally as part of the initial notification you will provide Your name address and your home and mobile telephone numbers Personal details necessary to confirm your identity Policy number The date of the incident The cause of the loss damage or injury Details of the loss damage or injury together with the claim value if known Names and addresses of any other parties involved or responsible for the incident Purchase dates and location of lost or damaged property For damaged property confirmation from a suitably qualified expert that the item you are claiming for is beyond repair Sometimes we or someone acting on our behalf may wish to meet with you to discuss the circumstances of the claim or to undertake further investigations Preferred Suppliers We take pride in the claims service we offer to our customers Our philosophy is to repair or replace lost or damaged property where we consider it appropriate and we have developed a network of contractors repairers and product suppliers dedicated to providing claim solutions Where we can offer repair or replacement through a preferred supplier but we agree to pay our customer a cash settlement then payment will normally not exceed the amount we would have paid our preferred supplier Initially a notification of any claim should be sent to Caunce O Hara & Company Ltd City Wharf New ailey Street Manchester M3 5ER Tel info@caunceohara.co.uk This information will enable us to make an initial evaluation on policy liability and claim value We may however request additional information depending upon circumstances and value which may include the following Original purchase receipts invoices instruction booklets or photographs

6 4 Personal ccident Illness and Travel Policy ssistance Services supporting this Policy This RS policy is supported by specialists in the provision of Medical and Security ssistance Services Firstssist and Drum Cussac are third party service providers approved by RS The advice and assistance provided by both Firstssist Services Limited and Drum Cussac can be accessed as follows Telephone: +44 (0) The services can be accessed 24 hours a day 365 days a year For your protection telephone calls may be recorded or monitored

7 Personal ccident Illness and Travel Policy 5 Travel nd Medical ssistance From Firstassist Firstssist employs a multilingual team of highly skilled and experienced professionals who provide travel and medical assistance services required by today s traveller We have customised the services Firstssist provide to protect the health of all travellers insured under this Policy When a traveller falls ill or suffers an accident whilst overseas or requires any other travel or medical-related help Firstssist s dedicated in-house teams of doctors nurses and case managers are on hand 24/7 Their highly experienced specialists provide travellers with the highest quality of advice support and assistance and an immediate response including emergency evacuation and repatriation Firstssist Pre Travel dvice Even before the Insured Journey commences Firstssist can help with the following advice on customs regulations currency limits and rules banking procedures and hours health matters and inoculation requirements visa requirements and procedures Firstssist Emergency Medical ssistance In an emergency an Insured or Insured Person can obtain immediate assistance by telephoning Firstssist The 24/7 operations centre has in house doctors and nursing staff a network of doctors and nurses throughout the world multilingual assistance case managers specialist travel agencies for immediate repatriation arrangements in the event of a medical emergency Firstssist Travellers Helpline s well as medical assistance the Firstssist Travellers Helpline will provide the following assistance advice on replacement of lost or stolen tickets passport or travel documents assistance in liaison with carrier on location of lost luggage items uninsured motoring assistance if the Insured Person s vehicle breaks down on the way to the airport uninsured domestic assistance for the duration of the Insured Journey - Firstssist will call out a tradesman to attend to an emergency at home but repairs and services necessary are payable by the Insured Person (with the exception of the cover provided under the Loss of Keys Special Extension to the aggage Insurance Section) emergency message relay to family referral to Embassy or Consulate where legal consultation is needed

8 6 Personal ccident Illness and Travel Policy Firstssist Identity Theft Helpline Over the phone preventative advice to help an Insured Person to safeguard their identity including guidance on measures to take to reestablish identity and credit rating Firstssist Essential Information Storage To enable an Insured Person to securely store important text based information from documents such as passports driving licence travel and debit / credit card details and retrieve these details from a secure website in the event of the loss of these documents whilst travelling Firstssist State enefit dvice following an insured Disablement claim Information and advice on the financial implications of long term absence from work due to injury Information on entitlement to State enefits Firstssist Counselling following an insured Death or Disablement claim With the prior written consent of the Company Firstssist will provide telephone or face to face counselling sessions as part of the claims service To subscribe to this service please go to Firstssist ereavement dvice and Counselling following an Insured Person s death Practical information and advice on how to register a death and the documentation required by the Registrar locate a will obtain Grant of Probate or Letters of dministration decide whether to consult a solicitor select a funeral director obtain appropriate counselling for the family left behind and explain the roles and duties of the Coroner

9 Personal ccident Illness and Travel Policy 7 Travel and Security ssistance From Drum Cussac Drum Cussac offer a range of services to meet the spectrum of travel and personal security challenges ensuring every Insured Person is well prepared has 24/7 access to security advice when travelling and an emergency response capability in the event of a crisis Drum Cussac is a specialist risk consultancy with offices on 4 continents They provide advice and solutions that enable our Policyholders to manage and mitigate their business risks Recognised for their specialist expertise innovative intelligence led approach and track record their services and solutions deliver security improvements to business operations worldwide Drum Cussac Travel Security dvice Even before the Insured Journey commences Drum Cussac can give advice on the following Detailed Country and City Specific Travel Reports Country Risk Profiles Traveller advice by country Travel wareness and High Threat Environment Training are offered on an uninsured basis dditional uninsured support from expert consultants on call on a 24/7 basis During the Insured Journey Drum Cussac provide the following Daily security alerts by text or online Daily updates to Country Risk Profiles 24/7 hotline to respond to security related emergencies To access these services please register at quoting your RS policy number as your unique identifier The information is designed for Risk Insurance and HR Managers and allows up to 5 registrations dditional registrations can be purchased at preferential rates Drum Cussac Emergency Security ssistance In support of the following Insurance Sections of this Policy Evacuation Insurance Section Hijack Kidnap and Detention Insurance Section Security Specialist Expenses Insurance Section ssistance and support is given to our policyholders through In house expert crisis management and response consultants In house security analysts network of response teams and security professionals throughout the world In country assistance and deployable resources in support and response to any emergency situation Specialist agencies for immediate repatriation in the event of a non-medical emergency natural disaster terrorist attack or life threatening situations Dedicated hijack kidnap and detention teams variety of in house specialist security service resources

10 8 Personal ccident Illness and Travel Policy Our Policyholders can also access a range of uninsured services from Drum Cussac at exclusive rates including Crisis and Incident Response planning workshops and exercises Preparation of travellers undertaking travel to high risk areas General security related travel advice Close protection planning and operational delivery To access a wider range of services from Firstssist or Drum Cussac at exclusive rates for RS policyholders please contact them quoting your RS Group Personal ccident and nnual usiness Travel Policy Number

11 Personal ccident Illness and Travel Policy 9 General Definitions ccident sudden unexpected unforeseen and identifiable incident ccident Medical Expenses The cost of medical surgical or other remedial attention treatment or appliances given or prescribed by a Medical Practitioner and all Hospital nursing home and ambulance charges ircraft ccumulation ll Insured Persons travelling in any aircraft or airship nnual Salary The total annual remuneration as declared and upon which the premium is based excluding payments for overtime commission or bonus payable by the Insured to the Insured Person at the date bodily injury following an ccident is sustained ssault While the Insured Person is engaged upon duties incidental to the usiness and as a direct result of assault other than by the explosion of any bomb or explosive device Cover will also apply where the assault is a direct consequence of the Insured Person s employment with the Insured aggage Clothing and personal effects suitcases trunks and other similar containers lap top computers dictaphones calculators personal organisers mobile telephones tools and trade samples accompanying the Insured Person on the Insured Journey or acquired by the Insured Person during the Insured Journey usiness The usiness description as detailed in the Schedule Child ny person who is unmarried and dependent and under 18 years of age or under 23 years of age if in full-time education Commuting While in the course of daily travel directly between residence (normal or temporary) and place of usiness (normal or temporary) Detention Unlawful prevention of an Insured Person from returning to Republic of Ireland or country of residence Director (including Partners and Members) C serving director (other than a nonexecutive director) of the Insured i) whose details have been notified to Companies Registration Office ii) who sits on the Insured s oard of Directors where the Insured is a company registered outside of the Republic of Ireland a member of a limited liability partnership any person who has signed the partnership deed of the Insured Endorsement n amendment to the Policy Terms Definitions Exceptions or Conditions including any Memoranda

12 10 Personal ccident Illness and Travel Policy Employee ny person under a contract of service or apprenticeship with the Insured excluding any Director Evacuation The necessary emergency evacuation of an Insured Person from a country or area within a country in which they are travelling other than their normal country of residence as recommended by C the Irish Government any legally empowered regulatory governmental or local authority in the country or region in which the Insured Person is travelling or the Company s security assistance provider Drum Cussac Evacuation Expenses The additional cost of travel accommodation and other expenses necessarily and reasonably incurred by the Insured or the Insured Person in evacuating the Insured Person to their normal country of residence or the nearest place of safety External Journey ny journey undertaken by the Insured Person on the usiness of the Insured (including incidental holiday taken in conjunction with the trip) which commences during the Period of Insurance and involves travel from the Insured Person s normal country of residence Travel from the Channel Islands and the Isle of Man to any destination will be regarded as an External Journey involving travel from the Insured s country of residence Insurance operates from the departure of the Insured Person from the Insured Person s residence or place of business in their normal country of residence (whichever occurs first) until arrival back at such residence or place of business (whichever occurs last) at the end of the journey Hijack/Hijacked Unlawful seizure of an aircraft or other conveyance in which the Insured Person is travelling Holiday Travel ny journey undertaken by the Insured Person which commences during the Period of Insurance other than on the usiness of the Insured necessitating an overnight stay Insurance operates from the departure of the Insured Person from the Insured Person s residence until arrival back at such residence at the end of the journey Hospital ny institution which meets fully every one of the following criteria C maintains permanent and full time facilities for the care of overnight resident patients and has diagnostic and therapeutic facilities for the surgical and medical diagnosis treatment and care of injured and sick persons by or under the supervision of a staff of Medical Practitioners and continuously provides a 24 hours a day nursing service supervised by state registered nurses or by persons with equivalent qualifications and The duration of an External Journey shall not exceed 31 days unless otherwise agreed in writing with the Company

13 Personal ccident Illness and Travel Policy 11 D is not other than incidentally an institution which provides full time facilities for i) mentally ill or mentally handicapped persons ii) nursing or convalescing iii) aged persons of 70 years or more iv) drug addicts v) alcoholics Incident ll individual losses arising out of and directly occasioned by one sudden unexpected specific event occurring at an identifiable time and place Insured s detailed in the Schedule Insured Journey s detailed in the Schedule Insured Person ny person or category of persons as detailed in the Schedule Cover applies until the expiry of the Period of Insurance in which the Insured Person attains the age of 64 years Internal Journey ny journey undertaken by the Insured Person on the usiness of the Insured (including incidental holiday taken in conjunction with the trip) which commences during the Period of Insurance and involves travel within the Insured Person s normal country of residence but only if the journey requires the Insured Person to obtain overnight accommodation away from their normal residence or involves flying as a passenger where the flight has been booked before commencing the journey Insurance operates from the departure of the Insured Person from the Insured Person s residence or place of business in their normal country of residence (whichever occurs first) until arrival back at such residence or place of business (whichever occurs last) at the end of the journey Kidnap Unlawful seizure of an Insured Person Loss of Eye Permanent and total loss of sight which will be considered as having occurred in both eyes if the Insured Person s name is added to the Register of lind Persons on the authority of a fully qualified ophthalmic specialist in one eye if the degree of sight remaining after correction is 3/60 or less on the Snellen scale (meaning seeing at 3 feet what the Insured Person should see at 60 feet) Loss of Limb in the case of a leg loss by permanent physical severance at or above the ankle or permanent and total loss of use of a complete foot or leg in the case of an arm loss by permanent physical severance of the four fingers at or above the meta carpo phalangeal joints (where the fingers join the palm of the hand) or permanent and total loss of use of a complete arm or hand Medical Practitioner ny legally qualified medical practitioner other than C an Insured Person a member of the immediate family of an Insured Person an Employee of the Insured

14 12 Personal ccident Illness and Travel Policy Money and Credit Cards Coins bank and currency notes cheques postal and money orders travellers cheques travel tickets and petrol and other coupons which have current monetary value and any credit charge cheque bankers or cash card issued in Republic of Ireland or country of residence to the Insured or the Insured Person provided that such money and credit cards had been obtained for travel accommodation meals and personal spending during the Insured Journey and belonged to the Insured Person at the time of the loss Nuclear Chemical or iological Cause Use of any nuclear weapon or device or the deliberate emission discharge dispersal release or escape of any solid liquid or gaseous chemical agent and/or iological agent Terrorism ny act including but not limited to the use of force or violence and/or threat thereof of any person or group(s) of persons whether acting alone or on behalf of or in connection with any organisation(s) or government(s) committed for political religious ideological or similar purposes including the intention to influence any government and/or to put the public or any section of the public in fear War War invasion act of foreign enemy hostilities (whether war be declared or not) civil war rebellion revolution insurrection or military or usurped power iological agent shall mean any pathogenic microorganism and/or biologically produced toxin(s) including genetically modified organisms and chemically synthesised toxins Proposal The Statement of Fact including any renewal declaration and information supplied by or on behalf of the Insured in addition to or in connection or in substitution thereof Republic of Ireland Republic of Ireland Spouse The spouse of an Insured Person or any other person who is not a Child who the Insured consents to be covered by this Policy

15 Personal ccident Illness and Travel Policy 13 Definition of Operative Times 24 hour t any time Occupational ccidents Only excluding Commuting While engaged on the Insured Person s occupation in the usiness or as a result of ssault or External Journey While the Insured Person is undertaking an External Journey Internal Journey While the Insured Person is undertaking an Internal Journey Holiday Travel While the Insured Person is undertaking Holiday Travel C at any time while travelling on the usiness of the Insured Insurance operates from the departure of the Insured Person from residence or normal place of usiness (whichever occurs first) until arrival back at such residence or normal place of usiness (whichever occurs last) at the end of the journey excluding Commuting Occupational ccidents Only including Commuting C While engaged on the Insured Person s occupation in the usiness or as a result of ssault or at any time while travelling on the usiness of the Insured Insurance operates from the departure of the Insured Person from residence or normal place of usiness (whichever occurs first) until arrival back at such residence or normal place of usiness (whichever occurs last) at the end of the journey including Commuting

16 14 Personal ccident Illness and Travel Policy General Conditions cquisition Clause If during the Period of Insurance the Insured acquires or creates any new office branch subsidiary or ssociated Company either directly or through one of its subsidiaries cover shall automatically apply from such date of acquisition or creation (provided either the wageroll or number of Insured Persons or travel pattern does not increase by more than 10% of the estimate provided at inception or renewal) at no additional charge Otherwise the Company agrees to provide cover from the date of creation or acquisition for a period of 30 days during which time the Insured shall provide any additional information and pay any additional premium as may be reasonably required by the Company ssociated Companies Where this Policy covers associated companies a list of these companies shall be provided to the Company Fraud Concealment or Deliberate Mis-statement If during the Period of Insurance the Insured Person commits an act of fraud concealment or deliberate mis-statement in relation to any matter affecting this Insurance the Policy will be rendered null and void in so far as it relates to such Insured Person but any fraud concealment or deliberate mis-statement made by or known to the Insured shall render the whole Policy null and void and all claims shall be forfeited Policy Cancellation This Policy may be cancelled by either the Insured or the Company by giving 30 days written notice to the Company or the Insured at their last known registered address The Company shall return a proportionate amount of the premium for the unexpired period subject to minimum premium requirements and provided no claims have been paid or are outstanding Cancellation of Terrorism or War Risks Cover The Company may cancel any insurance provided by this Policy against War or Terrorism by giving 7 days notice to the Insured at the Insured s last known registered address The insurance in respect of any journey involving travel outside the Insured Person s country of residence which commences before the expiry of such notice shall not be affected Choice of Law Unless the parties have agreed otherwise in writing any dispute concerning the interpretation of this Insurance shall be governed and construed in accordance with Republic of Ireland law and shall be resolved within the non-exclusive jurisdiction of the courts of Republic of Ireland

17 Personal ccident Illness and Travel Policy 15 General Claims Settlement Conditions ssignment The Company will not be bound to accept or be affected by any trust charge lien assignment or other dealing with or relating to this Policy Claims Notification The Company will have no liability under this Policy in respect of any matter which the Insured does not notify to the Company in accordance with the requirements of this condition s a condition precedent to the Insured s right to be indemnified under this Policy the Insured must provide written notification to the Company no later than 90 days of the occurring of any ccident Incident event or circumstance which may give rise to a loss which is covered under this Policy except as provided herein Evidence Required The Insured must produce for the Company at the Insured s own expense all the detailed particulars and evidence relating to the cause and amount of the loss damage or expenses If the Company considers it necessary each Insured Person must also agree to have a medical examination (which the Company will pay for) as often as the Company may require in connection with any claim Foreign Currency Claims involving foreign currency will be converted into the appropriate currency at the selling rate of exchange published on on the day nearest to the date of the loss or as otherwise paid via documented credit or debit card transaction or as agreed in advance in writing with the Company Interest Interest will not be added to any amount paid Other Insurances If at the time of any event giving rise to a claim there is any other insurance policy in force in the Insured s name which also covers the Insured or the Insured Person concerned for the same expense loss damage or liability then the Company will only pay a proportion of the claim such proportion being determined by reference to the cover provided under each of the relevant policies Personal ccident enefits will be payable in full subject to the Maximum Incident Limit (and inner limits where applicable) Other Interests The Insured s receipt shall discharge the Company s liability to pay any amount in respect of a claim The Insured Person or the Insured Person s personal representatives shall have no right to claim from or sue the Company If the Insured comprises more than one party having an interest in the Insured Person or the property insured the settlement made by the Company shall represent the total amount payable in respect of that Insured Person or property for all interests covered by this Policy Reasonable Care The Insured and each Insured Person must take all reasonable steps to avoid or minimise any loss or damage and must also make every effort to recover any property which has been lost or stolen

18 16 Personal ccident Illness and Travel Policy General Policy Exclusions The Company will not pay any claim under this Policy which is directly or indirectly as a result of or contributed to by 1 the Insured Person committing or attempting to commit suicide or as a result of self inflicted injury 2 the Insured Person engaging in flying of any kind other than as a passenger 3 War in Republic of Ireland or the Insured Person s country of residence 4 War or Terrorism occasioned by any Nuclear Chemical or iological Cause 5 radioactive contamination whether arising directly or indirectly 6 the Insured whilst engaged or taking part in military airforce or naval service or operations other than reserve or volunteer training 7 the Insured whilst engaged or taking part in mountaineering or rock climbing normally involving ropes or guides 12 any medical condition of the Insured Person for which medical advice or treatment has been given by a Medical Practitioner or Hospital during the last twelve months this exclusion shall not apply to any condition for which the Insured Person takes regular continuing medication provided that there has been no change in the type frequency or quantity of drugs within the last twelve months however no claims or expenses relating to such condition will be admitted hereunder in the event of the Insured Person s failure to take such drugs in accordance with the medical advice given 13 alcohol abuse drugs or solvents other than drugs prescribed by a registered Medical Practitioner but not for the treatment of drug addition 14 Holiday Travel unless this option is selected and shown as covered in the Schedule 15 participation in winter sports 16 the Insured Person engaging in any activities in which greater risk may be incurred than in the usiness description disclosed in the Certificate unless first notifying the Company and obtaining their written agreement to the amendment 8 the Insured whilst riding or driving in any kind of race 9 while the Insured Person is in a state of insanity 10 any psychiatric mental or nervous disorder of the Insured including anxiety or depression 11 physical or mental conditions or disabilities of a recurring or chronic nature from which an Insured Person suffered and was known to suffer prior to inception of this Insurance

19 Personal ccident Illness and Travel Policy 17 Personal ccident Insurance Section The Cover If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Death or Disablement the Company will pay to the Insured the appropriate enefit shown in the Schedule subject to Maximum Incident Limit (and inner limits where applicable) as detailed in the Schedule Special Definitions applying to this Section enefits under Standard Scale 1 Death 2 Loss of two or more Limbs or Loss of both Eyes or one of each 3 ) Loss of one Limb or Loss of one Eye ) Permanent total loss of speech C) Permanent total loss of hearing i) in both ears ii) in one ear 25% of enefit 3C)i) 4 Permanent Total Disablement from the Insured Person s usual occupation in the usiness 5 Temporary Total Disablement from the Insured Person s usual occupation in the usiness 6 Temporary Partial Disablement from at least 50% of the Insured Person s usual occupation in the usiness under Continental Scale 1 Death 2 Loss of two or more Limbs or Loss of both Eyes or one of each The amount payable for enefit 3 shall be a percentage of the amount for that enefit shown in the Schedule The following scale states the percentages applicable to the forms of disablement specified For forms of permanent disablement not specified the degree of disability will be assessed by comparison with the percentages shown in the scale without taking into account the Insured Person s occupation The appropriate percentage shall be applied to the amount for enefit 3 shown in the Schedule or to the Limit per Person under enefit 3 whichever is the lesser 3 ) Loss of one Eye 100% ) Permanent and total loss 100% of speech C) Permanent and total loss of hearing i) in both ears 100% ii) in one ear 25% Loss by permanent physical severance or permanent and total loss of use of D) one Limb 100% E) one big toe 15% F) any other toe 5% G) one thumb 30% H) one forefinger 20% I) any other finger 10%

20 18 Personal ccident Illness and Travel Policy Permanent total loss of use of J) shoulder or elbow 25% K) wrist hip knee or ankle 20% Removal by surgical operation of L) lower jaw 30% 4 Permanent Total Disablement from the Insured Person s usual occupation in the usiness 5 Temporary Total Disablement from the Insured Person s usual occupation in the usiness 6 Temporary Partial Disablement from at least 50% of the Insured Person s usual occupation in the usiness Disablement enefits 2 to 6 Operative Time The Operative Time shown in the Schedule shall have the meanings as shown in the Definitions of Operative Times Maximum Incident Limit The maximum amount the Company will pay under this Policy and any other policy of Personal ccident Insurance issued by the Company in the Insured s name in respect of all losses and in respect of all Insured Persons arising out of one and the same Incident The duration and radius of any one Incident shall be limited to 72 consecutive hours 100 miles No loss which occurs outside this distance or period shall be included in that Incident Special Conditions applying to this Section including Special Extensions enefits C The Company will not pay in respect of any one Insured Person more than one of enefits 1 to 4 in connection with the same ccident ny Disablement under enefits 2 to 4 must be proved to the reasonable satisfaction of the Company to be permanent and without expectation of recovery before the Company will pay the enefit The Company will pay any amount claimed for enefits 5 or 6 in addition to any amount claimed under enefits 1 to 4 in connection with the same ccident ny payment under enefits 5 or 6 will cease as soon as any enefit is paid under enefits 1 to 4 D i) If enefit 1 is not included for an Insured Person the Company will not pay for Loss of Limb or Eye or speech or hearing until at least thirteen weeks after the date of the ccident and the Company will only then pay if the Insured Person has not in the meantime died as a result of the ccident ii) If enefit 1 is included but the amount payable thereunder is less than the amount for Loss of Limb or Eye or speech or hearing the Company will not pay more than the amount for enefit 1 until at least thirteen weeks after the date of the ccident and the Company will only then pay the balance if the Insured Person has not died in the meantime as a result of the ccident

21 Personal ccident Illness and Travel Policy 19 E If enefit 3 under Continental Scale is claimed in respect of the same Insured Person for more than one form of Permanent Disablement as the result of the same ccident the total of the percentages payable shall not exceed 100% of the amount for enefit 3 If a claim is payable for loss of use of a whole member of the body a claim for parts of that member cannot also be made Disappearance In the event of the disappearance of an Insured Person if after a suitable period of time it is reasonable to believe that death has occurred as a result of bodily injury following an ccident enefit 1 shall become payable subject to a signed undertaking by the Insured that if the belief is subsequently found to be wrong such amount shall be refunded to the Company Exposure If an Insured Person suffers Death or Disablement as a result of exposure to the elements the Company will consider that as having been caused by bodily injury following an ccident Minors If the Insured Person is i) under the age of 16 or ii) aged 16 or 17 and is not one of the Insured s Employees The amount for enefit 1 will be limited to 10,000 enefit 4 shall read Permanent Total Disablement from gainful employment of any and every kind C No amount will be payable under enefit 5 or 6 Non-Employees If the Insured Person is not a an Employee or Director of the Insured enefit 4 shall read Permanent Total Disablement from gainful employment of any and every kind Special Extensions applying to this Section The following special extensions shall be payable in addition to any benefit paid under the Personal ccident Section enefits 1-6 of the Policy subject to the Maximum Incident Limit (and inner limits where applicable) as detailed in the Schedule ccident Medical Expenses If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of the incurring of ccident Medical Expenses the Company will pay up to 25% of any amount paid under enefits 1 to 6 subject to a maximum of 10,000 any one Insured Person ereavement Counselling If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Death for which enefit 1 is paid the Company will pay necessary expenses with the Company s prior written consent for either telephone counselling or face to face counselling or cognitive behavioural therapy from Firstssist as deemed appropriate by the Company to the Insured Person s spouse or Child up to 250 per week up to a maximum 2,500 any one Insured Person

22 20 Personal ccident Illness and Travel Policy Catastrophe If during an External Journey or Internal Journey an Incident results in payment of Death benefit for five or more Directors or Employees of the Insured who are covered under this Policy the Company will pay to the Insured an additional 25% of the total Sum Insured payable relative to those five Directors and Employees Catastrophe Critical Response Counselling If during the Period of Insurance any single Incident results in payment of the Death benefit for five or more Directors or Employees of the Insured who are covered under the Personal ccident Section of this Policy the Company will pay necessary expenses with the Company s prior written consent for specialist counselling support services from Firstssist for any Director or Employee of the Insured up to a maximum 2,500 Coma enefit If during the Operative Time the Insured Person sustains bodily injury following an ccident which within 90 days is the sole and independent cause of the Insured Person being in a continuous unconscious state the Company will pay 50 per full 24 hours up to a maximum of 52 weeks any one Insured Person while they remain in a continuous unconscious state Commuting Expenses If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of the Insured Person sustaining disablement from at least 50% of the Insured Person s usual occupation in the usiness the Company will pay necessary expenses for additional commuting costs necessitated to aid the Insured Person s return to work at the Insured s request up to 50 per week up to a maximum 250 any one Insured Person Counselling If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Disablement for which enefit or 6 is paid the Company will pay necessary expenses with the Company s prior written consent for either telephone counselling or face to face counselling or cognitive behavioural therapy from Firstssist as deemed appropriate by the Company to the Insured Person up to 250 per week up to a maximum 2,500 any one Insured Person Damage to Clothing and aggage If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Disablement for which enefit or 6 is paid and the Insured Person s clothing or aggage is lost damaged or destroyed as a direct or indirect result the Company will pay the cost of replacement as new or repair up to 500 per Insured Person subject to this not being included in any claim under the aggage Insurance Section or insured under a more specific insurance where a valid claim can be made Dependents enefit If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Death for which enefit 1 is paid the Company will pay an additional 2% per Child up to a maximum 10% of enefit 1

23 Personal ccident Illness and Travel Policy 21 Disability ssistance If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Disablement for which enefit 2 3 or 4 is paid the Company will pay necessary expenses incurred with the Company s prior written consent to make alterations to the Insured Person s home car or usual place of work as a direct and necessary result of the Disablement suffered up to a maximum of 10,000 Funeral Expenses If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Death the Company will pay the necessary costs incurred with the Company s prior written consent for funeral expenses up to a maximum of 10,000 any one Insured Person subject to this not being included in any claim under the Medical Repatriation and Emergency Travel Expenses Insurance Section Hospitalisation If during the Operative Time the Insured Person sustains bodily injury following an ccident which within 2 years is the sole and independent cause of the Insured Person being admitted to Hospital on the recommendation of a Medical Practitioner the Company will pay 50 per full 24 hours up to a maximum of 52 weeks any one Insured Person while they are a Hospital in-patient subject to this not being included in any claim under the Medical Repatriation and Emergency Travel Expenses Insurance Section Paralysis total loss of use of all four limbs bladder and rectum an additional 20% of the amount paid under enefit 2 or 4 total loss of use of two legs bladder and rectum an additional 10% of the amount paid under enefit 2 or 4 In respect of this Extension enefit 2 or 4 must be paid at 100% of the enefit shown in the Schedule Relocation Expenses If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of Disablement for which enefit 2 3 or 4 is paid the Company will pay necessary expenses incurred with the Company s prior written consent for stamp duty payments solicitors and estate agents fees and removal costs necessitated as a direct and necessary result of the Insured Person having to relocate as a direct result of the Disablement suffered up to a maximum of 10,000 any one Insured Person subject to there not being any claim paid under the Disability ssistance Extension Retraining If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of the Insured Person suffering Permanent Total Disablement from the Insured Person s usual occupation in the usiness for which the benefit is paid the Company will pay reasonable expenses incurred in retraining the Insured Person for an alternative occupation with the Insured up to a maximum of 5,000 If during the Operative Time the Insured Person sustains bodily injury following an ccident which within two years is the sole and independent cause of the Insured Person suffering paralysis the Company will pay the following benefit

24 22 Personal ccident Illness and Travel Policy Exclusions to this Section The Company will not pay any enefit where bodily injury following an ccident is the result of or is contributed to by 1 illness or disease (not resulting from bodily injury following an ccident) 2 any naturally occurring condition or degenerative process 3 any gradually operating cause 4 post traumatic stress disorder or any psychological or psychiatric condition (not resulting from bodily injury following an ccident)

25 Personal ccident Illness and Travel Policy 23 aggage Insurance Section The Cover If during an Insured Journey an Insured Person s aggage is lost damaged stolen or destroyed the Company will indemnify the Insured on behalf of the Insured Person concerned for the cost of repair or replacement The Company will pay the cost of replacement as new (or at the Company s option will replace as new) except for items that can be economically repaired (including clothing) where the cost of repair will be paid up to the appropriate Sum Insured shown in the Schedule in respect of any one Insured Person less any amount recoverable from the transport provider Special Extensions applying to this Section Delayed aggage In the event of the Insured Person s aggage being lost for more than 12 hours the Company will reimburse the Insured on behalf of the Insured Person up to 500 towards the cost of purchasing emergency replacement clothing toilet requisites and similar items ny amount paid under this extension will be deducted from any subsequent amount payable under the aggage Insurance Section for the same loss Loss of Keys If during an Insured Journey the keys to the external doors safes or alarms of the Insured Person s home or car keys are lost damaged stolen or destroyed the Company will indemnify the Insured on behalf of the Insured Person concerned for the replacement of the lock mechanisms up to 500 subject to this not being insured under a more specific insurance where a valid claim can be made utomatic reinstatement of Sum Insured after a loss In respect of any one Insured Person the Sum Insured shall not be reduced by the amount of any loss during any one Insured Journey and no additional premium shall be payable for such automatic reinstatement of cover Exclusions to this Section The Company will not pay 1 more than 500 or 25% of the appropriate Sum Insured whichever is the greater in respect of any one item pair or set 2 for loss or damage theft or destruction of a) Money and Credit Cards bonds negotiable instruments securities of any kind b) contact lenses c) sports equipment while in use 3 for loss or damage or destruction of caused by a) wear and tear depreciation moth vermin atmospheric or climatic conditions or any other gradually operating cause b) any process of cleaning dyeing repairing or restoring c) delay confiscation or detention by order of any Government or Public uthority 4 for mechanical or electrical breakdown or derangement 5 for loss damage theft or destruction of trade samples exceeding 1,000 in total or where insured under a more specific insurance where a valid claim can be made

26 24 Personal ccident Illness and Travel Policy 6 for any aggage that is lost damaged stolen or destroyed while being shipped as freight or under a bill of lading 7 the first 60 if each and every loss for each Insured Person 8 the first 20% of any loss in respect of tools 9 for loss damage theft or destruction whilst left in an unattended unless in a locked hotel room safe apartment holiday residence or boot of a motor vehicle 10 more than 1,500 or the Sum Insured as detailed in the Schedule for tools whichever is the lesser in respect of any one item pair or set Special Services applying to this Section - please refer to page 6 Firstssist Identity Theft Helpline Over the phone preventative advice to help an Insured Person to safeguard their identity including guidance on measures to take to reestablish identity and credit rating Firstssist Essential Information Storage To enable an Insured Person to securely store important text based information from documents such as passports driving licence travel debit and credit card details and retrieve these details from a secure website in the event of the loss of these documents whilst travelling

27 Personal ccident Illness and Travel Policy 25 Cancellation Curtailment Replacement Rearrangement and Change of Itinerary Insurance Section The Cover If the Insured or the Insured Person is forced to C D E Cancel an Insured Journey Curtail an Insured Journey Replace an Insured Person on an Insured Journey Rearrange to resume an Insured Journey Change the itinerary of a pre booked Insured Journey as a direct and necessary result of any cause outside the Insured s or the Insured Person s control the Company will indemnify the Insured for C D deposits and advance payments (on a proportionate basis in respect of Curtailment) charges for transport charges for accommodation and sustenance any other charges reasonably and necessarily incurred and that are forfeit under contract or are not otherwise recoverable The Company will pay up to the cost of the Insured Journey including those trips on the Insured s usiness funded wholly or in part by air miles but not exceeding the appropriate Sum Insured in respect of any one Insured Person subject to the Incident Limit as detailed in the Schedule with the exception of the first 50 of each and every loss each Insured Person Exclusions to this Section The Company will not pay in respect of any claim as a result of 1 disinclination to travel 2 redundancy of the Insured Person or any of the Insured s Directors or Employees 3 the Insured s financial circumstances 4 the financial failure or omission or neglect of any provider (or their agent) of transport or accommodation 5 regulations made by any Government or public authority 6 withdrawal from service temporarily or permanently of any means of transport on the orders or recommendation of any Port uthority or the Civil viation uthority or any similar body in any country 7 strike or industrial action which existed or of which advance notice had been given on or before the date on which the journey was booked 8 mechanical breakdown or failure of the means of transport on which the Insured Person is travelling or intends to travel unless it has been delayed by at least 2 hours 9 circumstances involving a person who is travelling or intending to travel against the advice of a Medical Practitioner or for the purpose of obtaining treatment 10 circumstances more specifically Insured under the Evacuation Insurance Section of this Policy